Basic Information
| Provider Information | |||||||||
| NPI: | 1447696950 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WALFALL | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | HUSSIEN | ||||||||
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| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9119 187TH ST | ||||||||
| Address2: | |||||||||
| City: | HOLLIS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114232407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3477311217 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5515 PEACH ST | ||||||||
| Address2: | |||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165092603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148688206 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2013 | ||||||||
| LastUpdateDate: | 05/13/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | OT015350 | PA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.